Troubles sexuels : comment trouver le courage d’en parler ?

sexologue
Accueil / Épanouissement
Rédigé par

Tristan Chevrier

Dernière mise à jour

15 mars 2021

Parler de ses troubles sexuels demande du courage, mais c’est à votre portée ! En sexualité, le dialogue, la communication, sont des facteurs déterminants. Pas seulement pour progresser dans nos relations, mais aussi lorsqu’on doit résoudre certaines difficultés.

Comment savoir si on doit consulter ? Et plus important, vers qui s’orienter ?

Parce que Mia espère une sexualité libre et décomplexée toutes les femmes, osez prendre la parole. Tous les problèmes sexuels ont une solution !

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Définition : troubles sexuels

La sexualité occupe une place essentielle et privilégiée dans nos vies, en étant un facteur déterminant pour notre épanouissement global.

Cette harmonie sexuelle, physiologique et psychique, peut pourtant être mise à mal, le plus souvent par des facteurs psychologiques (stress, anxiété, burn out, complexes, préjugés, etc.), mais aussi parfois socioculturels ou encore psychologiques et comportementaux (aversion ou inhibition sexuelle, peur, abus sexuel, fétichisme ou hypersexualité, etc.).

Parmi les symptômes physiques les plus courants, nous retrouvons : la dysfonction érectile, l’éjaculation précoce, le vaginisme ou encore lanorgasmie.

Souvent imbriqués dans une accumulation de facteurs bénins – psychologiques et/ou physiologiques – les troubles sexuels désignent généralement :

Enfin, notion primordiale pour un diagnostic, il faut savoir qu’un trouble sexuel entraîne toujours une forme de souffrance personnelle. Des comportements sexuels, même peu communs ou à côté de la « normalité », s’ils sont satisfaisants pour la personne et toujours partagés dans le consentement, ne doivent pas être considérés comme des troubles sexuels.

Ce critère de satisfaction (pour soi-même ou son/sa partenaire) est donc au cœur de la définition même de la sexualité, et un indicateur clé pour permettre au sexologue d’apporter son aide, un diagnostic et une prise en charge.

Consultez une sexologue en ligne sur Mia.co

Qu’est qu’un trouble du désir ?

Les troubles du désir sont le plus souvent liés à un manque de libido ou à une absence de désir sexuel, entraînant une souffrance personnelle.

On peut distinguer plusieurs troubles : primaires (présent depuis le début de la vie sexuelle) et secondaires (acquis avec le temps).

Les causes de ces troubles peuvent être :

  • Organiques : elles sont liées à certains traitements, médicaments, à une ménopause chirurgicale, etc.
  • Psychologiques : choc émotionnel, stress, anxiété, dépression, dysfonction sexuelle du partenaire, mauvaise stimulation sexuelle, relation dans le couple, événement de vie, etc.

Le plus souvent, un trouble du désir sexuel a plusieurs causes (organiques et/ou psychologiques) et un.e sexologue n’écarte aucune hypothèse afin de trouver les meilleures solutions possibles.

D’où l’importance d’être en confiance et de se sentir à l’aise avec son médecin : les troubles sexuels guérissent complètement dans 95% des cas.

Qu’est-ce qu’un trouble de l’excitation ?

Faisant intervenir les mêmes facteurs que pour les troubles du désir, un trouble de l’excitation est un problème en rapport avec un degré sexuel d’excitation organique et/ou psychique insuffisant, bloquant ainsi l’accès au plaisir.

Le vaginisme

Le vaginisme est défini comme la « contraction musculaire prolongée ou récidivante des muscles du plancher pelvien (élévateurs de l’anus et adducteurs) qui circonscrivent la vulve et le vagin, interdisant la pénétration vaginale ».

Il peut être primaire (présent depuis le début de la vie sexuelle), et souvent d’origine psychologique, mais il peut aussi avoir comme causes :

  •   Des facteurs socioculturels et/ou religieux ;
  •   Un antécédent d’abus sexuel ;
  •   Des problèmes relationnels avec le partenaire ;

Un vaginisme secondaire (acquis avec le temps) nécessite généralement un examen gynécologique complet, afin de déterminer s’il existe une cause organique :

  •   Présence d’infections  ;
  •   Un traumatisme de type déchirure, une épisiotomie mal cicatrisée, etc.
  •   L’influence de certains traitements ;

Les dyspareunies

Il s’agit des douleurs ressenties lors des relations sexuelles, particulièrement lors de la pénétration, et quasi systématiquement (dans toutes les situations, avec tous les partenaires, peu importe les pratiques, etc.)  

Il existe de nombreuses causes aux dyspareunies :

  • Des infections de la vulve ou du vagin (une mycose, un herpès, un eczéma, des verrues génitales, etc.) ;
  • Une inflammation de la vulve ;
  • Vestibulodynie ;

Selon les causes, les douleurs à la pénétration peuvent être plus ou moins profondes : à l’entrée du vagin, localisées sur la vulve, au fond du vagin, etc.

Les paraphilies sont-elles des troubles sexuels ?

Dans le langage commun, la paraphilie se caractérise comme une sexualité marginale ou atypique.

Dérivée du grec (para signifie « auprès de, à côté de » et philia « amour, porter de l’intérêt à »), la paraphilie décrit  des pratiques sexuelles en marge des pratiques « traditionnelles » ou considérées comme « normales ».

Ces impulsions, ces comportements ou ces fantasmes, doivent être présents depuis au moins 6 mois pour être considérés comme des troubles sexuels, et sont généralement à l’origine d’une détérioration de la vie sociale (ou d’un autre domaine important) et pouvant causer du désarroi.

Troubles sexuels : comment en parler ?

Cela touche à l’intime, à nos fantasmes, à nos désirs, mais aussi à nos difficultés personnelles et/ou conjugales.

Et même lorsqu’on est décidé.e à consulter un sexologue, on peut naturellement avoir des craintes et rencontrer des obstacles qui nous empêchent de franchir ce pas.

De la difficulté de constater le problème

C’est ainsi pour tout le monde. Il faut du temps pour constater qu’on a une difficulté sexuelle, et aussi pour l’accepter.

Parfois, on se laisse du temps, des vacances, on met ça sur le compte de la fatigue, du stress, du quotidien. Bref, le temps peut passer, et les problèmes peuvent rester ou se consolider.

D’autres fois, les difficultés sexuelles s’améliorent, et on peut penser que le problème est réglé.

Mais lorsque cette difficulté réapparaît (si elle réapparaît), le temps aura continué de passer, sans que le fond du problème ne soit compris. Apportant son lot de stress et de préoccupations.

Enfin, l’autre difficulté (une fois le problème accepté) est de savoir qui consulter.

À qui parler de ses difficultés sexuelles ?

Médecin généraliste, sexologue, psychologue, sexothérapeute : comment savoir à qui parler ?

Le médecin généraliste est-il la meilleure personne pour parler de problèmes sexuels ? Si non, quel spécialiste choisir ? Ce sont des questions normales que l’on se pose, une fois que l’on reconnait avoir des difficultés dans sa sexualité.

La crainte de consulter s’accompagne généralement de plusieurs peurs :

  • La peur d’être gêné.e (ou de gêner le médecin) ;
  • La peur d’être jugé.e, de ne pas être pris.e au sérieux ;
  • Ou que l’on mette ça sur le dos de l’âge ;
  • La peur de ne pas trouver de solutions, etc.

Enfin, certains médecins ne posent pas les questions de manière proactive, ce qui ne facilite pas les choses.

Le/la sexologue est donc l’interlocuteur privilégié.e pour discuter de problématiques sexuelles et trouver les meilleures solutions. En fonction des difficultés et grâce à son carnet d’adresse, il/elle peut ensuite orienter son ou sa patiente vers d’autres spécialistes.

Vous pouvez consulter une praticienne en ligne librement sur Mia.co.

Consultez une sexologue en ligne sur Mia.co

Comment dépasser les craintes d’une consultation ?

Aujourd’hui, la santé sexuelle est officiellement reconnue comme faisant partie intégrante de la santé générale. Et que, comme entité médicale, la santé sexuelle mérite les mêmes soins que d’autres problèmes de santé.

Les problèmes sexuels sont par ailleurs très fréquents : ils concernent 1 personne sur 5.

Les médecins sont donc de plus en plus formés à prendre en charge les problèmes sexuels ; certains se sont même spécialisés comme les médecins sexologues, les psychologues ou les kinésithérapeutes.

Il est possible de consulter à n’importe quel moment : que le problème existe depuis plusieurs mois ou depuis de nombreuses années, que le problème soit léger ou sévère, que vous soyez seul.e ou en couple ; il n’y a aucune limite.

On peut consulter simplement pour poser des questions, pour avoir des informations, ou pour une problématique qui nécessite des soins.

Enfin, un conseil judicieux avant une consultation : ne vous stressez pas à l’avance sur vos problèmes, ou la manière de les aborder avec votre sexologue. C’est au sexologue de vous guider et de vous poser les questions nécessaires.

Consultez de la manière la plus simple et naturelle possible ; même si cela vous paraît compliqué maintenant !

La première consultation est toujours la plus difficile. Mais une fois passé ce cap, on se rend compte que c’est tout à fait normal de discuter de ces sujets. Les sexologues sont habitués à parler des problématiques sexuelles et cherchent toujours des solutions avec bienveillance.

Vous devez vous sentir à l’aise avec votre interlocuteur/trice et pouvez changer de médecin à tout moment. Des sujets intimes peuvent être abordés, avec des difficultés à en parler. Mais jamais un médecin ne posera de questions impertinentes.

Son questionnaire sera toujours orienté pour résoudre la problématique qui vous touche directement.

Troubles sexuels : ce qu’il faut retenir 

Si vous ressentez le besoin de consulter un.e sexologue, – que ce soit simplement pour avoir des informations ou pour résoudre un problème – prenez rendez-vous simplement, comme si vous preniez rendez-vous auprès de n’importe quel autre professionnel de santé !

Le plus important est de valoriser cette démarche : notre santé sexuelle est déterminante sur nos vies au quotidien. Le/la sexologue sera d’abord là pour vous écouter, et vous guidera ensuite à travers ses questions.

Vous seul.e devez juger si une consultation est nécessaire, en vous posant quelques questions fondamentales. Suis-je préoccupé.e par un aspect de ma sexualité ? Est-ce que je rencontre des difficultés ? Est-ce une source de souffrance ? Pour quoi et pour qui consulter ?

Chacun vit sa sexualité de manière différente et a des attentes différentes. Vous ne devez pas consulter car vous avez peur de ne pas être dans la « norme », mais uniquement si vous en ressentez le besoin pour vous ou votre entourage. 

Gardez confiance et parlez ouvertement : les sexologues sont là pour vous aider. Vous pouvez consulter une sexologue en ligne facilement sur Mia.co.

Consultez une sexologue en ligne sur Mia.co

Consultez une spécialiste de la santé sexuelle et du bien-être par téléphone, messagerie ou vidéo, 7 jours sur 7.

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